Elderly people in Swedish elder care are still subject to serious misconduct. This is shown in a new report from the Health and Social Care Inspectorate (IVO), which has reviewed all 1,430 Lex Sarah reports within elder care during the years 2023–2025. The report describes everything from omitted care interventions to physical violence, sexual abuse, and psychological violations by staff.
The most common type of misconduct concerns elderly people not receiving the help they are entitled to. A total of 468 reports relate to omitted interventions and 443 reports concern improperly performed interventions. This can involve missed visits, insufficient help with hygiene, toilet visits, food and drink, medication, supervision, or transfers.
In several cases, it is described how elderly individuals were left lying without help despite sounding the alarm for staff. The report also shows that 150 reports, just over a tenth of all, concern elderly individuals subjected to physical violence, abuse, or sexual abuse by staff.
According to IVO, the cases include sexual violence, inappropriate touching, rough handling, pushing, hitting, restraint, and other degrading physical treatment.
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A further 170 reports concern poor treatment, psychological abuse, or other violations. A smaller number of cases relate to financial abuse, violence between residents, interventions carried out against the individual’s will, deficiencies in legal certainty, or shortcomings in the physical environment.
– IVO’s analysis shows that elderly people are exposed to serious misconduct and significant risks of serious misconduct within elder care. It is particularly worrying that violence and abuse against the elderly occur, as many have limited possibilities to protect themselves and depend on staff for their daily security and care, says Peder Carlsson, Department Head at the Health and Social Care Inspectorate (IVO).
Most Reports Concern Municipal Services
According to IVO, most reports come from special housing for the elderly, followed by home care services. Municipally run operations account for the largest share of the reports. However, the agency emphasizes that the number of reports alone does not say anything about the quality within different operations, as differences may depend on, for example, the operations’ mandates, size, and their propensity to report misconduct.
The review also shows deficiencies in how organizations investigate the incidents. In about half of the reviewed Lex Sarah reports, IVO has requested supplements because the investigations were insufficient. The authority finds that principals often focus on the individual incident without analyzing the root causes. The most common causes identified concern deficiencies in processes, routines, and guidelines.
Government Assignment
The report is part of a government assignment in which IVO is to analyze misconduct within elderly care and follow up on whether identified shortcomings are addressed. The final report is to be submitted to the government in January 2027.
This development comes as the government has recently appointed a special inquiry to strengthen security in elderly care. The investigation is, among other things, to review how abuses against the elderly can be prevented and how protection for the elderly can be strengthened.